Document Sample

                                    Examples from the Field

                A collection of sample tools, this document is a work-in-progress
                          informally compiled by Marjory Bancroft, MA

Most of the text below is excerpted or adapted from commentary by the authors of the tools
             or from promotional materials and does not reflect the opinions or
                           recommendations of Marjory Bancroft.

1. American Medical Association (AMA)

Organizational assessment toolkit: “Improving communication—improving care”: the
AMA Ethical Force program toolkit.

For information: For information on cost/ordering: https://catalog.ama-
     Intended to help health care organizations meet the needs of a diverse patient population.
     Assesses how effectively the organization communicates
     Can help organizations improve communication with all patient
     Questions focus on common communication problems, such as culture, language and
        health literacy gaps.

The toolkit includes the assessment instruments (surveys) and protocols, analysis guide and data
tools, and ideas for how to improve performance based on specific results—to be a catalyst for
productive organizational change.

The toolkit's surveys are available for viewing online. Anyone may download and use the
surveys for research purposes at no cost and without a license. To use the surveys for
organizational assessment, AMA requests that organizations purchase the toolkit and license.

2. Andrulis, Denis et al

       Conducting a Cultural Competence Self-Assessment

Available at no charge at

Authored by: Dennis Andrulis, SUNY/Downstate Medical Center, Brooklyn, NY, in
collaboration with Thomas Delbanco, Beth Israel Deaconess Medical Center, Boston, MA,
Laura Avakian, Massachusetts Institute of Technology, Boston, MA, Yoku Shaw-Taylor, Public
Health Foundation, Washington, DC

   A tool for an organizational audit of cultural competence in health care
   Helps validate organizational understanding of the ethnic and cultural composition of its
    patient and employee populations
   May hope to ensure access to appropriate treatment and effective communication
   May reveal opportunities for the organization to make itself more attractive to diverse
   Can demonstrate that the organization values diversity

3. Annie E. Casey Foundation

                       Race Matters: Organizational Self-Assessment

A one-page questionnaire on staff competencies and organizational operations that purports to
offer a racial equity score followed by a “next steps” analysis. It also suggests tools for

4. American Speech Language Hearing Association

                          Self-Assessment for Cultural Competence

Available at no charge at

   Involves an interactive web-based tool designed to help evaluate cultural competence.
   Includes cultural competence checklists, a cultural competence awareness assessment and a
    questionnaire about “How Does Your Caseload Compare?”
   Addresses personal reflection, policies and procedures and service delivery
   Assesses demographic and caseload changes related to culturally/linguistically diverse
    (CLD) populations.
   Is intended to help organizations to increase and improve service delivery

5. Association of University Centers on Disabilities Assessment of Organizational Cultural

No longer online. Formerly available at Contact Marjory
Bancroft at for a copy.

        A survey intended to assess organizational cultural competence for university centers on

6. Vancouver, B.C. Ministry for Children and Families

                          Cultural Competency Assessment Tool
No longer online. Formerly available at;
Contact Marjory Bancroft at for a copy.

This was a 7-page tool intended to assist the Vancouver region of the Ministry for Children and
Families and community based agencies of all sizes in the Vancouver area in becoming more
culturally competent. The goal was to enhance services and programs to ethnocultural
communities, including newcomers.

7. Andrulis et al
   The Cultural Competence Self Assessment Protocol for Health Care Organizations and
Developed by Dennis Andrulis, Thomas Delbanco, Laura Avakian and Yoku Shaw-Taylor, this
is an innovative approach to assessing organizational cultural competence. The protocol builds
upon the Georgetown University Child Development Center's Continuum of Cultural
 Intended for use by health care providers, including hospitals and clinics, to conduct
    organizational assessments of their cultural competence.
 Particularly useful for services involving racially and ethnically diverse populations
 Questions are organized according to four cornerstones of cultural competence: a) health care
    organization's relationship with its community; b) the administration and management's
    relationship with staff; c) inter-staff relationships at all levels; d) the patient/enrollee-provider
The protocol allows organizations to score responses and then place themselves on a five point
spectrum of cultural competence, ranging from inaction to a fully realized "learning"
organization. The protocol can serve as a formal organization-wide review tool or as a
department- or clinic-specific assessment instrument.

8. Outcomes Management Group and Ohio Department of Mental Health

Consolidated Culturalogical Assessment Tool Kit (C-CAT)

      The toolkit for organizational assessment in mental health includes training materials,
promotional materials, a facilitator’s guide, user workbook, assessment tools and a database. It

can be used by a variety of shareholders. The toolkit must be purchased at a cost of $750 or
higher, depending on the number of licenses purchased.

9. Hasnain-Wynia, R., Pierce, D., Haque, A., Hedges Greising, C., Prince, V., Reiter, J. (2007)
Health Research and Educational Trust Disparities Toolkit.
The HRET toolkit is a web-based tool that provides hospitals, health systems, clinics, and health
plans information and resources for systematically collecting race, ethnicity, and primary
language data from patients. Registration is free. Development of the toolkit included input from
a National Advisory Panel.

By using this Toolkit, health care organizations can assess their organizational capacity to collect
this information and implement a systematic framework designed specifically for obtaining race,
ethnicity, and primary language data directly from patients/enrollees or their caregivers in an
efficient, effective, and respectful manner.

10. Carr, W. and Willis, J (2002) for U.S. Department of Health and Human Services, Health
Resources and Services Administration Group (2002), Indicators of Cultural Competence in
Health Care Delivery Organizations: An Organizational Cultural Competence Assessment

This detailed, practical assessment tool was created to contribute to the methodology of cultural
competence assessment. The product - An Organizational Cultural Competence Assessment
Profile - builds upon previous work in the field, such as the National Standards for Culturally
and Linguistically Appropriate Services (CLAS) , and advances the conceptualization and
practical understanding of how to assess cultural competence at the organizational level.

The specific objectives of this project were to: 1) develop an analytic framework for assessing
cultural competence in health care delivery organizations; 2) identify specific indicators that can
be used in connection with this framework; and 3) assess the utility, feasibility and practical
application of the framework and its indicators. The project was implemented through a contract
with The Lewin Group, Inc. HRSA's Office of Minority Health and Office of Planning and
Evaluation provided both oversight and substantive input to the project.

11. Wilson-Stronks, A. et al (2008 for The Joint Commission. One Size Does Not Fit All:
Meeting the Needs of a Diverse Health Care Population.
Both a tool (Chapter 8) and a report on a tool, this detailed report provides It provides a
framework and self-assessment tool for hospitals to develop and employ practices for meeting
diverse patient needs. The report recommends that organizations:
Identify the needs of the patient population being served and assess how well these needs are
being met through current

       Bring people across the organization together to explore cultural and language issues by
        sharing experiences, evaluating current practices, discussing barriers, and identifying
       Make assessment, monitoring, and evaluation of cultural and language needs and
        services a continuous process
       Implement a range of practices spanning all four themes in a systemic manner aligned
        with patient needs and organizational

12. Mason, J.L. (1995) Cultural Competence Self-Assessment Questionnaire: A Manual for
This manual contains the Cultural Competence Self-Assessment Questionnaire (CCSAQ), a
measure designed to assist service agencies working with children with disabilities and their
families in self-evaluation of their cross-cultural competence. The measure is based on the Child
and Adolescent Service System Program Cultural Competence Model. This model describes
cultural competency in terms of four dimensions: attitude, practice, policy, and structure. The
manual provides information on the application and administration of the measure, its outcomes,
its reliability, its content validity, the scoring guide, and presentation of resulting data in a
comprehensible format. Appendices include two different versions of the questionnaire--one for
direct service providers and one for administrative staff. Also included is a scale for collecting
demographic information.

13. National Center for Cultural Competence Cultural Competence Health Practitioner
The Cultural Competence Health Practitioner Assessment (CCHPA) was developed at the
request of the Bureau of Primary Health Care (BPHC), Health Resources and Services
Administration (HRSA), U.S. Department of Health and Human Service (DHHS).
The CCHPA captures a wide range of data in its six subscales including: /Values & Belief
Systems, Cultural Aspects of Epidemiology, Clinical Decision-Making, Life Cycle Events,
Cross-Cultural Communication and Empowerment/Health Management/. Assessment of
practitioners is only one aspect of examining cultural and linguistic competence within an
organization, and should not be used in isolation. For more information about self-assessment
tools & processes see:

14. National Center for Cultural Competence (2006) Cultural and Linguistic Competence
Policy Assessment (CLCPA)
The Cultural and Linguistic Competence Policy Assessment (CLCPA) was developed by the
National Center for Cultural Competence (NCCC) at the request of the Bureau of Primary Health

Care (BPHC), Health Resources and Services Administration (HRSA), U.S. Department of
Health and Human Service (DHHS) to assist community health centers to advance and sustain
cultural and linguistic competence.

The CLCPA is intended to support health care organizations to:
 improve health care access and utilization
 enhance the quality of services within culturally diverse and underserved communities
 promote cultural and linguistic competence as essential approaches in the elimination of
   health disparities.

The NCCC has also developed a companion Guide for Using the Cultural and Linguistic
Competence Policy Assessment Instrument that provides step-by-step instructions on how to
conduct an organizational self-assessment process.

15. Robert Wood Johnson Foundation, Speaking Together, National Language Services
Network Measures

The George Washington University Department of Health released the language services
performance measures being piloted and tested in its learning collaborative. The measures,
developed at the request of the Robert Wood Johnson Foundation, allow hospitals to examine
how they communicate with non-English-speaking patients, and focus attention on how hospital
staff can better structure and manage language services programs to have effective, efficient and
timely communications with patients with limited English proficiency (LEP).

Lingjuan Ma Lingjuan Ma MS
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